Operate, actions
Actions
Downstream actions derived from the resolved identities. Proposed actions wait for an operator; suppressed actions wait for a steward decision.
Eligibility engine
1,339
Eligibility conflict resolved
1,339 proposed
Claims processor
9,112
Orphan claim re-pointed
9,112 executed
Outreach
7,319
Outreach address corrected, Outreach suppressed pending steward
2,993 proposed4,326 held
Next-best-action
3,896
Care coordination outreach, New member onboarding
3,896 proposed
Member services
4,974
Duplicate member record retired
4,974 executed
Actions
26,640 derived from the last resolution run
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| ACT-003012 | Orphan claim re-pointed Claims processor | CLM-420106 → UHC-03354-04 (Zachary Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003013 | Orphan claim re-pointed Claims processor | CLM-413531 → UHC-69055-38 (Brian Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003014 | Orphan claim re-pointed Claims processor | CLM-423000 → UHC-81991-63 (Ashley Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003015 | Orphan claim re-pointed Claims processor | CLM-427265 → UHC-04166-33 (Doris Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003016 | Orphan claim re-pointed Claims processor | CLM-412034 → UHC-43336-98 (Yuki Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003017 | Orphan claim re-pointed Claims processor | CLM-402646 → UHC-64475-41 (Joyce Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003018 | Orphan claim re-pointed Claims processor | CLM-426943 → UHC-58714-09 (Katherine Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003019 | Orphan claim re-pointed Claims processor | CLM-400534 → UHC-65574-14 (Carl Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003020 | Orphan claim re-pointed Claims processor | CLM-420994 → UHC-50500-21 (Ruth Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003021 | Orphan claim re-pointed Claims processor | CLM-416428 → UHC-43474-82 (Ralph Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003022 | Orphan claim re-pointed Claims processor | CLM-425959 → UHC-03338-45 (Aisha Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003023 | Orphan claim re-pointed Claims processor | CLM-419063 → UHC-44726-52 (Wayne Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003024 | Orphan claim re-pointed Claims processor | CLM-424316 → UHC-64314-13 (Emily Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003025 | Orphan claim re-pointed Claims processor | CLM-424816 → UHC-78961-66 (Amy Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003026 | Orphan claim re-pointed Claims processor | CLM-422979 → UHC-73169-03 (Kayla Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003027 | Orphan claim re-pointed Claims processor | CLM-409339 → UHC-15649-07 (Bryan Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003028 | Orphan claim re-pointed Claims processor | CLM-429574 → UHC-49733-88 (Dorothy Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003029 | Orphan claim re-pointed Claims processor | CLM-409160 → UHC-82037-47 (Evelyn Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003030 | Orphan claim re-pointed Claims processor | CLM-429965 → UHC-63818-98 (Janice Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003031 | Orphan claim re-pointed Claims processor | CLM-429271 → UHC-24025-42 (Kayla Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003032 | Orphan claim re-pointed Claims processor | CLM-403747 → UHC-17557-30 (Cynthia Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003033 | Orphan claim re-pointed Claims processor | CLM-404781 → UHC-69416-72 (Elijah Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003034 | Orphan claim re-pointed Claims processor | CLM-409502 → UHC-68420-99 (Adam Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003035 | Orphan claim re-pointed Claims processor | CLM-404092 → UHC-44276-58 (Jeremy Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003036 | Orphan claim re-pointed Claims processor | CLM-414055 → UHC-64849-57 (Katherine Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003037 | Orphan claim re-pointed Claims processor | CLM-413402 → UHC-92235-70 (Michelle Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003038 | Orphan claim re-pointed Claims processor | CLM-432603 → UHC-21303-62 (Maria Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003039 | Orphan claim re-pointed Claims processor | CLM-426193 → UHC-55817-74 (Stephen Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003040 | Orphan claim re-pointed Claims processor | CLM-425557 → UHC-98623-51 (Kelly Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003041 | Orphan claim re-pointed Claims processor | CLM-413577 → UHC-04229-09 (Philip Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003042 | Orphan claim re-pointed Claims processor | CLM-403226 → UHC-64259-10 (Yuki Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003043 | Orphan claim re-pointed Claims processor | CLM-419615 → UHC-80234-32 (Lawrence Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003044 | Orphan claim re-pointed Claims processor | CLM-409497 → UHC-35903-72 (Rebecca Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003045 | Orphan claim re-pointed Claims processor | CLM-428491 → UHC-59733-49 (Rachel Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003046 | Orphan claim re-pointed Claims processor | CLM-432657 → UHC-92766-64 (Sean Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003047 | Orphan claim re-pointed Claims processor | CLM-415228 → UHC-04658-83 (Carlos Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003048 | Orphan claim re-pointed Claims processor | CLM-419325 → UHC-54283-43 (Cheryl Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003049 | Orphan claim re-pointed Claims processor | CLM-404962 → UHC-42310-56 (Gary Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003050 | Orphan claim re-pointed Claims processor | CLM-424772 → UHC-03381-49 (Andrea Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003051 | Orphan claim re-pointed Claims processor | CLM-408651 → UHC-87938-64 (Katherine Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003052 | Orphan claim re-pointed Claims processor | CLM-422881 → UHC-10931-15 (Jonathan Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003053 | Orphan claim re-pointed Claims processor | CLM-430895 → UHC-05548-06 (Katherine Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003054 | Orphan claim re-pointed Claims processor | CLM-400910 → UHC-48195-05 (Terry Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003055 | Orphan claim re-pointed Claims processor | CLM-401234 → UHC-19454-66 (Amanda Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003056 | Orphan claim re-pointed Claims processor | CLM-416664 → UHC-37231-04 (Hannah McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003057 | Orphan claim re-pointed Claims processor | CLM-429221 → UHC-69901-39 (Aisha Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003058 | Orphan claim re-pointed Claims processor | CLM-414930 → UHC-38548-43 (Abigail Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003059 | Orphan claim re-pointed Claims processor | CLM-416432 → UHC-49808-01 (Douglas Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003060 | Orphan claim re-pointed Claims processor | CLM-402124 → UHC-51969-60 (Isabella Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003061 | Orphan claim re-pointed Claims processor | CLM-420289 → UHC-42069-39 (Sarah Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 |
Derivation rules
Evaluated after every gold rebuild
- 1Eligibility conflict resolvedThe records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
- 2Orphan claim re-pointedA claim arrived without a member ID. Resolution attached it to an identity that has one, so the claims processor can now pay it against the right member.
- 3Outreach address correctedThe most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
- 4Outreach suppressed pending stewardThe record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
- 5Care coordination outreachThree or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
- 6New member onboardingA single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
- 7Duplicate member record retiredTwo or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.